“What kind of support do I need to be successful as an ethnic minority medical student?” A qualitative study

Abstract

Background To be in alignment with the increasing diversity in the patient population, ethnic minorities should have appropriate representation in health care professions. Medical students from ethnic minorities therefore need to be successful in their medical studies. The current literature highlights that they underperform in comparison with the ethnic majority. The aim of the present study is to gain insight into what medical students from ethnic minorities experience during their education and what they need to become or stay motivated and to perform to their full potential. Methods Medical students from ethnic minorities from year 1 to 6, enrolled at Amsterdam UMC, Faculty of Medicine, Vrije Universiteit, the Netherlands, were invited via email to participate in this study. Semi-structured interviews were conducted, using an interview guide, from August–October 2018. A constructivist paradigm was adopted. Results Eighteen medical students from ethnic minorities (three from year 1, three from year 2, one from 3, four from year 4, two from year 5, and three from year 6) participated in this study. Students’ negative experiences could be categorized as follows: (1) the effect of discrimination (2) lack of representation of ethnic minority role models, (3) lack of a sense of belonging, (4) lack of a medical network, (5) differences and difficulties in cultural communication and language, and (6) examiner bias in clinical assessments. Examples of support tips relating to these experiences are: increasing awareness about diversity and other religions, providing support groups, having visible ethnic minority role models, and facilitating support in networking. Conclusions Findings of this study suggest that medical students from ethnic minorities have negative experiences that influence their education. Supporting these students is essential for creating a good and safe educational and practical environment for ethnic minority students.

Student ethnicity predicts social learning experiences, self‐regulatory focus and grades

“…Our findings are consistent with literature showing that ethnic minority students perceive that their ethnicity negatively affects their school outcomes. 5,7 A possible explanation of our findings lies in the situational effects that clinical training has on students. Assuming that formal curricula do not intentionally create group-based differences in experiences and outcomes, the explanation could be found in the van ANDEL ET AL.…”

“…57 Indeed, students' social capital in medical school, such as the likelihood of naming a clinician in one's network, could differ across student ethnicities. 7,58 Further research is needed to explain the relationship between student ethnicity and clinical evaluations, and again, the hidden curriculum could play a role here. 59 Our study was limited by the use of ethnic minority and ethnic majority categorizations.…”

“…Furthermore, ethnic minority students may be more uncertain about their social belonging at medical school, for example, their social academic fit. 4,7,16,20 As mentioned above, self-regulatory focus can be divided into two self-regulatory systems, a so-called 'promotion', which sets goals in terms of aspirations and accomplishments, and a 'prevention' focus, which sets goals in terms of responsibility and safety. 8 Self-regulatory focus can be chronic as well as situationally induced, implying that people can have both orientations simultaneously.…”

Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings

“…The exact nature of implicit racial bias between peers in healthcare education settings is fragmented and unclear due to difficulties in differentiating unconscious habitual responses from subtle discrimination and modern forms of racism [ 49 ]. However, it can be inferred from the wider literature that implicit racial biases exist within these environments and could be present in interpersonal communication between peers [ 4 , 47 , 50 ]; also see commentaries, [ 37 , 38 ].…”

“…Qualitative studies examining student experiences have highlighted the lack of diverse faculty and assessors as a factor that adds to negative experiences faced by racial and ethnic minority group healthcare students. These studies report that racial and ethnic minority group healthcare students experience and witness racial prejudice and stereotyping from academic and clinical staff, adjust behavior to counteract negative stereotypes, and endure increased stress to prove intellectual ability [ 2 , 5 , 47 , 50 ]. For example, one minority student said ‘you have to be exceptional to be considered average’ [ 2 ] (p. 6).…”